Affordable Care Act impacting Alaska businesses in significant ways.

• Author: Barbour, Tracy
• Position: INSURANCE

The Patient Protection and Affordable Care Act, commonly called Affordable Care Act (ACA), was enacted in 2010 to expand healthcare to all Americans. The law, in part, requires businesses with more than fifty full-time equivalent employees to provide health insurance for their full-time employees or face stiff penalties.

The ACA also provides for a Federally Facilitated Marketplace, or "Marketplace," where individuals can shop for health insurance. In 2015, employers will be able to purchase insurance from a section of the federally-run exchange known as SFIOP, an acronym for the Small Business Health Options Program. Those that do so can take advantage of federal tax credits and other benefits if certain criteria are met.

While some people praise the ACA for making medical care more accessible, others protest that it is making health insurance more complex and costly. Unique perspectives about the ACA's impact on businesses in Alaska are gained from different stakeholders--including government agencies, a business advocacy group, an employee benefits firm, and an insurance company and brokerage.

US Department of Health and Human Services

When sharing her perspective of the ACA's impact on Alaska's business climate, Susan Johnson paints a picture in broad strokes. Johnson is Alaska's regional director of the US Department of Health and Human Services, which oversees administration of the federal Marketplace. 'The ACA, Johnson says, has helped improve competition, availability, and choice, as well as bringing a new level of transparency and fairness to healthcare. Now, since qualified health plans have to provide certain coverage, it's much easier to make an apples-to-apples comparison between plans.

According to Johnson, people are a company's biggest asset, and providing health coverage is an investment that pays off for businesses in multiple ways. "If you have healthier people, they will cost you less," she says. "You're going to have a lower absenteeism rate, lower turnover, and a more stable group of employees that will be more productive workers."

So far, the ACA has served Alaska well, Johnson says. During the first year of the enrollment that was completed in 2014, almost thirteen thousand Alaskans chose Marketplace plans. In addition, up to forty-three thousand Alaskans can't be denied coverage for pre-existing conditions. About nine thousand young adults have gained or retained insurance because they can stay on their parents' plans until age twenty-six. And in the first ten months of 2013, two thousand seniors and disabled individuals saved an average of $877 on medications.

One aspect of the ACA Alaska is not experiencing is Medicaid expansion. However, hospitals--and other businesses--would benefit tremendously from expanding Medicaid, Johnson says. Broadening the program would enable them to provide less uncompensated care, which would provide downward pressure on healthcare costs. "For example, with Medicaid expansion in Washington state, Seattle-based Harborview Medical Center, the area's largest safety-net provider, saw its proportion of uninsured patients decline from 12 percent in 2013 to 2 percent this past spring," she says. "The drop off is expected to increase revenue by $20 million in 2014."

Johnson says the ACA is bringing about improvements to healthcare in Alaska, and those improvements will make things better for businesses overall. "Although some business owners may initially see higher insurance...